Like all good moms, I want my kids to grow up safe and healthy. I want to make decisions that will benefit them right now, but I also need to think about things that could help them in the future. I feel like it’s a big job and a lot is depending on me. That is why I wanted to learn more about the HPV vaccinebefore my children were old enough to get it. I wanted to make an informed choice, and I had all kinds of questions.

What is HPV, anyway? Could a vaccine actually protect my children from cancer? Are there side effects? What about the scary rumors I heard on the internet? Why is the vaccine given at age 11? Are my kids really at risk for HPV, or is this unnecessary medicine?

I wrote this article to share the answers I found to my questions, and to hopefully convince other parents to think about how they can protect their own children, not only now, but in the future.

What is HPV anyway?

HPV stands for human papilloma virus. HPV lives on soft mucous membranes and skin. Usually, it can be found on the genitals of an infected person, but it can also infect the anus, mouth and throat.

Some strains of HPV viruses cause genital warts, while others can cause tumors or cancers to grow. While there are many different types of HPV, there are several different HPV vaccines licensed by the Food and Drug Administration (FDA). The bivalent HPV vaccine (Cervarix) prevents the two HPV types, 16 and 18, which cause 70% of cervical cancers. There is also a quadrivalent HPV vaccine (Gardasil) which prevents against four HPV types: HPV 16 and 18, as well as HPV 6 and 11, which cause 90% of genital warts. The quadrivalent vaccine has also been shown to protect against cancers of the anus, vagina and vulva and is the only HPV vaccine licensed for use in males. And just last week, the FDA approved a new HPV vaccine (Gardasil 9) which will protect against nine different strains has the potential to prevent approximately 90 percent of cervical, vulvar, vaginal and anal cancers.

Can the HPV vaccine actually protect my child from cancer?

The primary cancer the HPV vaccine is designed to protect against is cervical cancer, the same cancer that is checked for when women go in for a pap smear. However, because the vaccine stops dangerous HPV viruses anywhere in the body, it may help protect against some cancers of the penis, throat, mouth, and anus. This is one reason it is recommended for boys as well as for girls. (The other reason is to protect future partners from cervical cancer.) Read more…

After viewing the PBS NOVA film “Vaccines – Calling the Shots”, I began wondering what the film’s impact would be. I’ll admit that the film was very ambitious. It addressed the science behind vaccines, why they work, how they work & even touched upon how people assess risk and decide whether to vaccinate or not. All this in less than an hour.

Of course, no one should expect this film to be the one defining piece that will convince people to vaccinate. Certainly it may reinforce the decision of those who already choose to vaccinate. And it may give pause to those who would otherwise refrain from vaccinating. But most importantly, this film is a valuable tool to help educate people about the science behind vaccines, inform the public about the importance of herd immunity and the dangers of not vaccinating, and open the door for civil dialogue about common vaccine safety concerns.

Looking back on the tweets I sent during the premiere, I realized that the film touched upon some of the most important immunization related issues I hear from parents day after day. My goal now is to encourage as many people as possible to see this film (available online) and to use it as a way to encourage further conversation.

Of course, the film began with the usual caveats:

In the US more than 90% of parents vaccinate & most follow the recommended schedule.

Vaccine history may repeat itself. @PaulOffit explains “If you start to decrease vaccination rates you start to see the diseases reemerge.”

In order to appreciate the value of vaccines, the film began by addressing the recent resurgence of diseases like pertussis (whooping cough) and measles. It explained the infectious nature of these diseases, illustrated how epidemics are tracked and spread, and allowed viewers to see a tearful mother watching her infant child laying in a hospital bed and battling violent coughing fits brought on by an incurable disease known as pertussis.Read more…

As we prepare for the challenges of 2014, we want to thank everyone who has contributed to our success in 2013. Once again, the past year has been one of tremendous growth. We’ve seen a record number of views and shares on a variety of Shot of Prevention blog posts and we’re especially grateful to our new blog contributors and many new subscribers.

In looking back over our efforts from this past year, we would like to share a list of some of our most popular blog posts from 2013. We hope that you will revisit these posts and share them with others so that we can engage more people in these important immunization discussions.

Top 5 Shot of Prevention Blog Posts of 2013

Why Some Parents Are Refusing the HPV Vaccine For Their Children: This post not only identifies some of the most common reasons parents are choosing to refuse the HPV vaccine for their children, but it includes links to scientific data that can help parents gain a better perspective regarding the HPV vaccine, including information on safety and efficacy. Click here to read this year’s most popular post.

Legal Responsibilities in Choosing Not to Vaccinate: This guest post, written by vaccine advocate and law professor Dorit Rubinstein Reiss, explores the legal ramifications associated with those that choose not to immunize themselves or their children. What if a unvaccinated individual is responsible for spreading a disease that causes permanent injury or even death to another individual? Would it be reasonable to hold them liable? Read more about the considerations here.

Think Chickenpox is Party Worthy? Think Again: Some people mistakenly believe it is safer to sicken their children by exposing them to “wild” diseases than to obtain immunity through vaccinations. However, the misconception that wild viruses and “natural” immunity is better for a child is a dangerous one, especially when parents are purposely infecting their children with chickenpox rather than get them vaccinated. If parents are going to take their chances with the wild varicella virus, it’s important that they first acknowledge the risks and understand that chickenpox can be dangerous and deadly. This post, which explains the concerns of intentional exposure and highlights the unfortunate death of Jesse Lee Newman, can be read here.

Why We’re Still Talking About Vaccines and Autism: Each day, as new babies are born and more children are diagnosed with autism, questions of vaccine safety rush front and center for a new set of parents. In March of 2013, the CDC released new information about the prevalence of Autism Spectrum Disorder which then reignited conversations about the safety of immunizations. This blog post includes links to various resources that address the subject of autism and vaccines. But while concerns may linger, the science is in. Read more in the post here.

Vaccine Refusal and the Politics of School Vaccination Exemptions: As vaccine exemption rates climb across various parts of the U.S., so do outbreaks of vaccine preventable diseases which are threatening the health of our children. In 2013, many states responded to these concerns by establishing new policies for school immunization exemptions and attempting to legislate their way toward better public health. Find out which states are taking action and how you can be alerted to legislative initiatives in your state by reading the post here.

If you have suggestions for topics you would like us to address in 2014, please feel free to add them to the comments below. If you enjoy our posts please remember to subscribe to Shot of Prevention by clicking the link in the top right corner of this page. You can also join us for more immunization news and discussion on our Vaccinate Your Baby Facebook page.

Thanks again for your continued support and best wishes for a happy and healthy new year!

A few weeks ago I wrote about the fact that Katie Couric’s new daytime television show Katie was planning to air a segment about HPV vaccine. After hearing the proposed line-up for the show it was clear that the HPV vaccine was not going to be portrayed favorably. And as expected, the conversation has blown up all over the internet in the past 24 hours with many reporters and bloggers calling out Katie Couric and her producers for how poorly they’ve handled this important conversation.

Unfortunately, daytime television ratings are driven by emotion and controversy and Katie Couric’s producers know that. So despite the overwhelming research available on the safety and efficacy of the HPV vaccine, that information was not adequately presented to the millions of viewers of her show.

But there was one other thing notably missing.

It was the voices of those who have suffered with HPV related cancers. And those family members who speak out on behalf of those lost to HPV related cancers.

Since the Katie Couric neglected to include a single cervical cancer survivor, I’m encouraging anyone who has had a personal experience with an HPV related cancer to speak out and let others know just how terrifying it has been for you. You may share your story in the comments below or send them to us at shotofprevention@gmail.com. And I would like to encourage everyone to share your opinions of the episode with one of the show’s producers (Beth.Cochran@katiecouric.com).

Below are just a few of the HPV related stories that are featured on the Shot By Shot website. They are all very compelling and emotional and I hope that someday they will get the kind of attention that the Katie show has given to those critical of the vaccine.

In this video, Heather Burcham shares her story of cervical cancer just two months before she died. Her hope was to change just one person’s life by encouraging others to get the HPV vaccine.

This is an excellent video filmed at the national Cervical Cancer Coalition conference in Atlanta, GA, in January 2013 which highlights stories from cervical cancer survivors and family members of women who have died from the disease. These personal stories highlight the devastating impact of cervical cancer and emphasizes the importance of prevention in the form of vaccines and regular screening–prevention that can save lives.

There are a lot of reasons why I love vaccines, but most importantly it’s because they save lives. However, my appreciation of vaccines has also helped to elevate my appreciation of science. This week has been another perfect example. News coverage of several recent studies out this week help to illustrate the benefit of vaccines and provide further evidence of their efficacy.

Reduction in Pneumococcal Disease

At a IDWeek conference meeting earlier this week, researchers presented preliminary data and conclusions from a soon-to-be published study regarding the efficacy of the 13-valent pneumococcal conjugate vaccine. MedPage Todaycovered the conference and reported that rapid uptake of the vaccine led to substantial reductions in invasive and noninvasive pneumococcus-related outcomes across all age groups after only 2 years. Vaccination was tied to a 59% reduction in invasive pneumococcal disease-related hospitalizations in children younger than 5 years old, and a 25% reduction in related hospitalizations in adults.

The FDA approved the 13-valent version of the pneumococcal conjugate vaccine for use in pediatric patients 6 months to 5 years old back in 2010. The new vaccine replaced a seven-valent version of the vaccine by adding protection against six additional strains of bacteria which accounted for 62% of cases of invasive pneumococcal disease not covered by the previous vaccine.

The study pointed to the “substantial herd immunity that was achieved,” by pointing to the 90% reduction of total invasive pneumococcal disease that occurred in older children and adults who were not immunized. In other words, community immunity is even helping to protect those who are not vaccinated.

Image of unvaccinated child with varicella lesions in various stages. (Photo courtesy of the American Academy of Pediatrics)

Dramatic Decline in Incidence of Chicken Pox

Another development we’ve seen in regards to vaccine efficacy relates to the implementation of a two-dose varicella vaccination program which began in 2006. According to study findings published in Pediatrics this week, the incidence of varicella (also know as chicken pox) has decreased across all age groups since the double dose vaccination program took effect. Additionally, hospitalizations have declined by more than 40% during 2006 to 2010 compared with 2002 to 2005, and more than 85% compared with 1995 to 1998. Read more…

This post is not the result of an official survey. Rather, it’s a collection of the most common explanations I’ve heard parents make when refusing HPV vaccine for their children, followed by points to consider.

REASON #1: My child is not/ will not/ should not be having sexual relations. So why would they need an HPV vaccine?

As a mother to five daughters I get it. Every parent wants to believe that their son or daughter will remain abstinent until marriage. And some may. But the reality is that some children, even as young as 12 and 13, are already involved in sexual relations and this reality is what has influenced the age at which the HPV vaccine is recommended. Here is what the studies suggest:

Some parents may be surprised to learn that sexual intercourse is not necessary for infection. Oral-genital and hand-genital transmission of some genital HPV types is possible and has been reported. Studies show that HPV was detected in 46% of females prior to first vaginal sex. Based on this information, it’s possible that a person can become infected during their first sexual encounter. Even if someone remains abstinent until marriage, there’s no guarantee that the person they are marrying isn’t already infected.

The way I see it, most children by the age of 11 can understand that the HPV vaccine can protect them from various types of cancers, but not from pregnancy and STDs. It’s a simple matter of communication by which the parents can explain that the vaccine doesn’t equate to a free pass to have sex. If a child chooses to refrain from sexual relations, I would venture to guess that it has more to do with their upbringing and strong moral character, than whether or not their parents choose to protect them with the HPV vaccine.

Last year I went on a cycling weekend out in California with four other women, all of us doctors. We were there to celebrate my dear friend’s recovery from breast cancer. Of course there was the usual debauchery– feather boas included– that takes place when 5 middle-aged women have left their husbands in charge of the children. But there was still a sense of sobriety, knowing why we were all there and wishing that “chemo” and “reconstructive surgery” weren’t the frequent topics of conversation that they were. And with cancer on our minds, this group of five female physicians soon found ourselves talking about—what else?—genital warts.

The OB-Gyn in the group waxed poetically about how excited she was to immunize her patients against HPV—the human papillomavirus. It’s long been known that HPV is responsible for nearly all cases of cervical cancer in women. HPV is a nasty little virus that spreads from skin-to-skin, person-to-person. Often this occurs during sexual contact but can also be passed from mother to child. Many people infected with HPV don’t even realize it, meaning they continue to pass the infection to others. Hence the some 6 million people infected every year with HPV. And while HPV causes unsightly genital warts, that’s not what bothers physicians about it. What bothers us is that HPV causes cancer. And cancer, to put it bluntly, sucks.

Good news is there’s a vaccine that can protect us from the most common strains of HPV that cause cancer. It is currently recommended that girls between the ages of 11 and 12 receive 3 doses of the vaccine. As of 2011, this was extended to include the routine vaccination of boys. Naturally this caused a stir, since HPV is usually blamed for causing cervical cancer. And a boy isn’t supposed to have a cervix. So what was this? An act of chivalry? A sort of “holding the door” open so cancer wouldn’t whack a girl in the head? Read more…